VBAC

A previous caesarean does not automatically determine the mode of birth in the next pregnancy. Trial of labour after caesarean (TOLAC) is the planned attempt at vaginal birth; vaginal birth after caesarean (VBAC) is the outcome if that attempt succeeds. The decision is built around two questions: is vaginal birth clinically reasonable with this uterine scar, and can the planned birth occur where an emergency caesarean and neonatal resuscitation can be provided without delay? The same scar that may permit a safe vaginal birth can, rarely, separate during labour. This makes careful pre-labour assessment and continuous intrapartum surveillance central to safe care.